Correlation of perinatal outcomes with amniotic fluid assessment techniques in high-risk pregnancies in a Tertiary Hospital in Southern Nigeria.

Lawrence O Omo-Aghoja,Ayotunde T Adeyinka,Ovoke Egagifo

doi:10.4314/ahs.v21i3.42

Abstract

Oligohydramnios is a predictor of fetal compromise and a useful tool in pregnancy management. It has been assessed using various techniques, including two-diameter pocket (2-DP) and amniotic fluid index (AFI). To determine which of these two techniques best diagnose oligohydramnios and predicts adverse perinatal outcomes. This was a comparative cross-sectional study conducted at Delta State University Teaching Hospital, Oghara in southern region of Nigeria over eight months period. One hundred high-risk pregnant women were recruited and ultrasound determination of amniotic fluid was performed using AFI and 2-DP. The women were followed up till delivery to determine adverse perinatal outcomes. The indices of validity of AFI and the 2-DP were calculated and compared. The 2-DP had a higher sensitivity than AFI for adverse outcomes in high-risk pregnancies complicated by oligohydramnios. The 2-DP technique should preferably be used for the assessment of oligohydramnios in high-risk pregnancies.

Highlights

Amniotic fluid (AF) provides physical protection, space for movement and growth, and enhancement of lung development for the fetus but it constitutes a vital sign for the evaluation of fetal well-being.[1,2] The metabolism of AF is a fine dynamic balance between the fetus and the mother.[1]
This study showed that amniotic fluid index (AFI) technique identified more normal volumes (5-25cm) compared to the 2-DP technique (15-50cm2)
This study revealed that despite the statistically significant association with adverse outcomes, the AFI had a poor sensitivity for adverse perinatal outcomes

Summary

Introduction

Amniotic fluid (AF) provides physical protection, space for movement and growth, and enhancement of lung development for the fetus but it constitutes a vital sign for the evaluation of fetal well-being.[1,2] The metabolism of AF is a fine dynamic balance between the fetus and the mother.[1]. Oligohydramnios is a predictor of fetal compromise and a useful tool in pregnancy management. It has been assessed using various techniques, including two-diameter pocket (2-DP) and amniotic fluid index (AFI). One hundred high-risk pregnant women were recruited and ultrasound determination of amniotic fluid was performed using AFI and 2-DP. The 2-DP had a higher sensitivity than AFI for adverse outcomes in high-risk pregnancies complicated by oligohydramnios. Conclusion: The 2-DP technique should preferably be used for the assessment of oligohydramnios in high-risk pregnancies. Correlation of perinatal outcomes with amniotic fluid assessment techniques in highrisk pregnancies in a Tertiary Hospital in Southern Nigeria.

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Discussion

Conclusion